The progressive ageing of the working population and the increase in related chronic diseases tend to affect working capacity. The aim of this study was to evaluate a Workplace Disability Management Program (WDMP) within a pediatric hospital. Absenteeism due to healthcare workers’ (HCWs) pre- and post- WDMP and the related costs were used for the program evaluation. The Return on Investment (ROI), the Break-Even Analysis (BEA) and the value of the average annual productivity of HCWs who took advantage of the Disability Management (DM) interventions to assess the economic impact of the program, were also used. The HCWs enrolled in the program were 131 (approximately 4% of hospital staff), of which 89.7% females and with an average age of 50.4 years (SD ± 8.99). Sick leave days of the HCWs involved decreased by 66.6% in the year following the end of WDMP compared to the previous one (p < 0.001). The total estimated cost reduction of absenteeism is 427,896€ over a year. ROI was equal to 27.66€. BEA indicated that the break-even point was reached by implementing the program on 3.27 HCWs. The program evaluation demonstrated the particular effectiveness of the implemented WDMP model, acting positively on the variables that affect productivity and the limitation to work.

ObjectivesWhen assessing the economic value of vaccines, decision makers should adopt a full societal perspective. One approach for estimation of the fiscal impact of a disease is to use the human capital method to determine productivity losses. The aim of this study was to test an analytical framework developed for the estimation of the fiscal impacts of vaccination programs for influenza (FLU), pneumococcus (PC), and herpes zoster (HZ), in Italy.MethodsWe tested the framework in a two-stage analysis. First, we estimated the fiscal impact of the disease, second we performed a cost–benefit analysis of the individual benefits of vaccination against the cost of the vaccine. To estimate the fiscal impact of the diseases, the human capital approach was used. Epidemiological data were extrapolated from the literature. A Monte Carlo simulation enabled exploration of the uncertainty in the model variables.ResultsFor FLU, assuming 2.1 million people infected, the total expected impact was EUR 999,371,520; the estimated fiscal impact was EUR 159,563,520. For PC, assuming 90,000 people infected, the total impact was EUR 148,055,040 and the estimated fiscal impact was EUR 23,639,040. For HZ, assuming 6,400 people infected, the total impact was EUR 4,777,200, with EUR 630,000 resulting from a decrease in fiscal taxation.ConclusionsIn conclusion, our work shows how traditional methods aimed at estimating the cost of illness from a social perspective can be improved by additionally considering the fiscal impact, which accounts for the decrease in fiscal revenues due to illness.

Objectives: The objective of the present policy analysis was to understand how a disinvestment approach to the process of health technology assessment (HTA), applied to the field of medical devices, might help Italian policymakers to properly spend the resources in healthcare.Methods: Previous international and national experiences in disinvestment for medical devices were reviewed. Precious insights for the rational expenditure of the resources were derived by assessing the evidence available.Results: The disinvestment of ineffective or inappropriate technologies or interventions with an inadequate value-for-money ratio has become a growing priority for National Health Systems. Different international disinvestment experiences of medical devices were identified and described through a rapid review. Although most of them have a strong theoretical framework, their practical application remains difficult. In Italy, there are no examples of large and complex HTA-based disinvestment practices, but their importance is becoming increasingly acknowledged, especially given the need to prioritize the funds provided by Recovery and Resilience Plan.Conclusions: Anchoring decisions on health technologies without reassessing the current technological landscape through a robust HTA model might expose to the risk of not ensuring the best employment of the resources available. Thus, it is necessary to develop a strong HTA ecosystem in Italy through adequate consultation with stakeholders to enable a data-driven and evidence-based prioritization of resources toward choices characterized by high value for both patients and society as a whole.

Background: Over 20% of healthcare workers (HCWs) are active smokers. Smoking is a targeted issue for workplace health promotion (WHP) programs. Objective: Our study aims to evaluate the effectiveness of the Stop Smoking Promotion (SSP) intervention, a 6-hour training course for HCWs, which took place from May 2018 to July 2019. Methods: We compared HCWs who successfully quit smoking (n = 15) to those who did not (n = 25) in terms of Sickness Absence Days (SADs). Moreover, we conducted an econometric analysis by calculating the return on investment and implementing a break-even analysis. Findings: Among the 40 enrolled workers, a success rate of 37.5% was observed after a span of over two years from the SSP intervention (with nurses and physicians showed the best success rate). Overall, participants showed a noticeable absenteeism reduction after the SSP intervention, with a reduction rate of 85.0% in a one-year period. The estimated ROI for the hospital was 1.90, and the break-even point was 7.85. In other words, the organization nearly doubled its profit from the investment, and the success of at least eight participants balanced costs and profits. Conclusion: Our pilot study confirms that WHP programs are simple and cost-saving tools which may help improve control over the smoking pandemic in healthcare settings.

In un contesto caratterizzato dalla crescente rilevanza attribuita al ruolo esercitato dai pazienti nelle scelte di politica sanitaria, il presente studio offre per la prima volta una fotografia su alcune caratteristiche salienti delle associazioni dedite all'advocacy. Tali associazioni, che nascono come aggregazione di piu cittadini e pazienti interessati da un medesimo ambito patologico, hanno acquisito nel tempo il ruolo fondamentale di loro rappresentanti in termini di bisogni, valori e aspettative. I dati impiegati nel presente studio sono stati rilevati in via primaria attraverso una survey nazionale e in via secondaria attraverso l'osservazione delle performance realizzate dalle medesime. Obiettivo dello studio e dimostrare se e come le competenze possedute dai leader delle associazioni dedite all'advocacy nonche le caratteristiche organizzative delle associazioni stesse esercitino un impatto sul raggiungimento degli obiettivi per i quali le associazioni sono state istituite.

The healthcare sector significantly contributes to global greenhouse gas emissions. Among the various strategies available, exploring the integration of environmental sustainability into Health Technology Assessment (HTA) presents a potential avenue for addressing these impacts. The HTA Core Model, widely utilized by European HTA agencies, evaluates healthcare technologies across nine domains; however, environmental considerations remain peripheral and are primarily confined to certain safety-related aspects. This paper examines the potential role of Life Cycle Assessment (LCA) in complementing HTA to better address environmental impacts. LCA offers a systematic methodology to evaluate environmental effects across the full lifecycle of a product, from raw material extraction to disposal. Through the analysis of pharmaceuticals, telemedicine, and surgical practices, the study identifies critical environmental impacts at various lifecycle stages, illustrating how LCA could support more informed and sustainable decision-making in healthcare. These findings underscore the diverse environmental impacts associated with healthcare technologies and highlight the need for tailored strategies to mitigate them. This point of view emphasizes the importance of initiating discussions on developing a framework to incorporate environmental impacts into HTA systematically, promoting healthcare decisions that prioritize both human and environmental healths.